Health Affairs 9/9/2021

The use of quality measurement to identify opportunities for improvement in how, where, and when care is delivered has driven remarkable advances and saved countless lives. At the same time, persistent racial and ethnic disparities in health and health care call attention to a striking need to address equity more directly in our health care infrastructure. Harnessing quality measurement as a tool for advancing a more equitable health care system offers great promise. Realization of this promise begins with a simple but thus far elusive goal: providing transparency into existing disparities in care.

Equity is a key pillar of health care quality, as set forth in seminal quality reports such as Crossing the Quality Chasm and Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Reducing disparities requires the quantification of gaps in care using equity-focused quality measurement. Quality measurement can help narrow or eliminate racial and ethnic disparities by shedding light on where current disparities exist, as well as motivating health systems to respond to population-level disparities. 

The National Committee for Quality Assurance (NCQA) has begun implementing a stratification by race and ethnicity in its health plan quality measure set, the Healthcare Effectiveness Data and Information Set (HEDIS), to hold plans accountable for addressing disparities in care and outcomes among their patient populations. Incorporating social determinants of health-focused data into quality measurement and improvement has been shown to decrease costs, improve outcomes, and promote equity in health and health care.

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